| Background and objective: Glioma(English: Gliomas)called glioma,occurred in neuroectodermal tumors,cancer is a disease of the central nervous system,glial cells derived lesions.According to incomplete statistics,the incidence of gliomas account for about 40% of all intracranial tumors [1] In recent years,the incidence of brain tumors,especially gliomas rising,has become a threat to human health and life of mainstream cancer diseases.Thanks to updated medical imaging equipment,technology upgrading and,glioma patients either mortality or morbidity has significantly reduced the rapid development of microsurgical techniques,but at the same time we still visible in the research,whether preoperative or postoperative cognitive impairment in patients with glioma still exist,significantly affect the prognosis and quality of life in patients with the disease.Tucha [2] studied 139 patients with brain tumors showed that over 90% of these patients have varying degrees of cognitive dysfunction phenomenon.Therefore,by glioma cognitive function in patients with systemic assessment and regular monitoring to assess the therapeutic effect of glioma more and more attention of clinicians,for the damage caused by glioma cognitive function,has become one hotspot research.In this study,by collecting the patient’s cognitive impairment gliomas,categorized its related factors,analyze their relevance to help clinicians in the course of clinical care,the personal circumstances of patients,can effectively relevant factors intervention in advance,under the premise of clinical treatment and reduce patient risk of cognitive impairment occurs,improved patient outcomes and quality of life.Methods: 1.Inclusion criteria were collected Yijishan Wannan Medical College Hospital,100 cases of glioma patients from January 2014 to January 2016 between According to all patients after admission all its skull enhanced MRI,,and one of the Some patients were head CT scan,surgical removal of all or part of,postoperative pathological examination confirmed glioma.Then patients received MoCA Reviews.2.Time for all patients embodiment MoCA evaluation were organized in admission after 7 days and 3 months.3.In recognition of impairment indicators set influencing factors selected for the patient’s age,sex,education,the glioma occurrence site,the size and volume of glioma tumor pathological grade glioma,and analysis related to cognitive impairment factor.4.Statistical Methods: The mean ± standard deviation(x ±s)analysis of the measurement data,measurement data with two sets of student t test or t ’test;count data using chi-square test(χ2 test,sample size <40,using Fisher’s exact test)count data are expressed in absolute value.All data were analyzed by multivariate logistic regression analysis method for further studies to test as α = 0.05,P <0.05,indicating significant difference,statistically significant.Results:1.MoCA Chinese version at the time of cognitive function in patients with glioma were evaluated,with good internal consistency,and the use of assessment scales is also more reliable,MoCA overall Cronbach a coefficient,standardized Cronbach a coefficient> 0.7.2.Each sub-scale results from MoCA can be known,feature comparison of preoperative cognitive glioma patients,showed a significantly lower score for each sub-item,and P <0.05,suggesting significant.3.For patients with MoCA Reviews,glioma patients at admission varying degrees of cognitive impairment,about 54.0%,in each sub-item,and there is significant difference statistically significant visual space,attention,memory,executive function force,language,orientation and named seven areas.4.After 7 days,for patients with gliomas MoCA Reviews,cognitive dysfunction,72.0% exists to varying degrees,significantly higher when compared to admission.5.After 3 months,for patients with gliomas MoCA Reviews,38.0% have varying degrees of cognitive dysfunction,compared with postoperative 7th improved significantly,and the contrast between the groups was statistically significant.6.Age on cognitive function in patients with glioma affect significantly compared glioma patients over 40 years old group,40 patients with glioma and cognitive dysfunction following groups lighter.7.Cognitive function in patients with glioma and gender will not be significantly affected by the situation of education,compared to no significant difference between groups.8.Sites of glioma(brain’s right and left hemispheres),tumor size and pathological types of glioma patients cognitive function will cause a significant impact,and among significant differences between groups,suggesting that there are statistically significant,glial tumor is located in the left cerebral hemisphere severe cognitive impairment.Glioma tumor volume the greater the greater cognitive impairment.High-grade glioma patients with severe cognitive impairment in patients with low-grade gliomas.Conclusion: Good MoCA Scale reliability,scale a more complex set of sub-item,capable of glioma patients more comprehensive and rational evaluation of cognitive function.So the damage on cognitive function in patients with glioma screening,it is recommended to use MoCA evaluation,so that screening is more sensitive,more specific,and reduce misdiagnosis phenomenon.Glioma patients in the preoperative 54.0% have varying degrees of cognitive impairment,cognitive impairment in patients after surgery on the 7th significantly heavier than admission;after 3 months than after 7 days,cognitive dysfunction patient improved significantly;cognitive function in patients with glioma and their gender will not be significantly affected by the level of education,the contrast between the two groups was not statistically significant;the age difference on cognitive function in patients with glioma a significant effect,and the comparison between the groups was statistically significant;compared with the right hemisphere,gliomas occur in cognitive dysfunction in patients with left hemisphere caused significantly more weight;the larger the glioma tumor volume,patient awareness the severe damage;compared with low-grade gliomas and high grade gliomas occur in patients with significantly more severe cognitive impairment.Glioma patients often accompanied by cognitive impairment of function,so the clinical practice,patients with glioma cognitive function screening is necessary,but a variety of factors could cause glioma patients with cognitive impairment,and therefore analysis of these factors is to achieve early prevention,early treatment is the key,is to protect cognitive function in patients with glioma,the key to improve the quality of life of patients. |
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